Individual provider Active NPI

Georgina Katyusca Maldonado

  • Case Manager/Care Coordinator
  • Shreveport, LA
National Provider Identifier
1336824036
Registry record updated Jun 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Practice address
2100 E 70TH St Ste a
Shreveport, LA 71105-5363
Phone
(318) 227-4999
NPI assigned
Jun 20, 2023
Last updated
Jun 20, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 20, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X NU Primary

Addresses

Primary practice location

2100 E 70TH St Ste a
Shreveport, LA 71105-5363

Mailing address

6900 Buncombe Rd Lot 51
Shreveport, LA 71129-9496
Phone (318) 553-0850

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Hands of Hope Behavioral Health, LLC. CurrentSince Jun 25, 2023 Accepting new patients
Hands of Hope Behavior Health Case Manager/Care Coordinator CurrentSince May 7, 2024 Accepting new patients

Locations

2100 E 70th St
Ste A
Shreveport, LA 71105
Phone (318) 227-4999

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1687219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687219200000",
    "number": "1336824036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6900 BUNCOMBE RD LOT 51",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711299496",
            "telephone_number": "318-553-0850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 E 70TH ST STE A",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711055363",
            "telephone_number": "318-227-4999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALDONADO",
        "first_name": "GEORGINA",
        "middle_name": "KATYUSCA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-06-20",
        "last_updated": "2023-06-20",
        "certification_date": "2023-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shreveport, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.